As the human population grows-tripling in the past century while, simultaneously, quadrupling its demand for water-Earth's finite freshwater supplies are increasingly strained, and also increasingly contaminated by domestic, agricultural, and industrial wastes. Today, approximately one-third of the world's population lives in areas with scarce water resources. Nearly one billion people currently lack access to an adequate water supply, and more than twice as many lack access to basic sanitation services. It is projected that by 2025 water scarcity will affect nearly two-thirds of all people on the planet. Recognizing that water availability, water quality, and sanitation are fundamental issues underlying infectious disease emergence and spread, the Institute of Medicine held a two-day public workshop, summarized in this volume. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.

This volume describes the methods used in the surveillance of drinking water quality in the light of the special problems of small-community supplies, particularly in developing countries, and outlines the strategies necessary to ensure that surveillance is effective.

The safety of the nation's drinking water must be maintained to ensure the health of the public. The U.S. Environmental Protection Agency (EPA) is responsible for regulating the levels of substances in the drinking water supply. Copper can leach into drinking water from the pipes in the distribution system, and the allowable levels are regulated by the EPA. The regulation of copper, however, is complicated by the fact that it is both necessary to the normal functioning of the body and toxic to the body at too high a level. The National Research Council was requested to form a committee to review the scientific validity of the EPA's maximum contaminant level goal for copper in drinking water. Copper in Drinking Water outlines the findings of the committee's review. The book provides a review of the toxicity of copper as well as a discussion of the essential nature of this metal. The risks posed by both short-term and long-term exposure to copper are characterized, and the implications for public health are discussed. This book is a valuable reference for individuals involved in the regulation of water supplies and individuals interested in issues surrounding this metal.

Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate The Dietary Reference Intakes (DRIs) are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. This new report, the sixth in a series of reports presenting dietary reference values for the intakes of nutrients by Americans and Canadians, establishes nutrient recommendations on water, potassium, and salt for health maintenance and the reduction of chronic disease risk. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate discusses in detail the role of water, potassium, salt, chloride, and sulfate in human physiology and health. The major findings in this book include the establishment of Adequate Intakes for total water (drinking water, beverages, and food), potassium, sodium, and chloride and the establishment of Tolerable Upper Intake levels for sodium and chloride. The book makes research recommendations for information needed to advance the understanding of human requirements for water and electrolytes, as well as adverse effects associated with the intake of excessive amounts of water, sodium, chloride, potassium, and sulfate. This book will be an invaluable reference for nutritionists, nutrition researchers, and food manufacturers.

This publication gives a comprehensive review and analysis of potential diseases associated with recreational water activities in marine, freshwater, spas/whirlpools and swimming pools, drawing on information on the ecology and health aspects of a variety of pathogens. Issues discussed include: the factors related to infection and disease severity, susceptible sub-populations, the credibility of association with recreational water use, a severity rating system for prioritising public health protection measures, and pathogen summaries. It will be useful to all those concerned with recreational water quality, including environmental and public health professionals, local authorities and user groups.

"Troesken draws on many independent sources of evidence, including data from the Negro Mortality Project, econometric analysis of waterborne disease rates in blacks and whites, analysis of case law on discrimination in the provision of municipal services, and maps showing the location of black and white households.

The second edition of Microbiology of Waterborne Diseases describes the diseases associated with water, their causative agents and the ways in which they gain access to water systems. The book is divided into sections covering bacteria, protozoa, and viruses. Other sections detail methods for detecting and identifying waterborne microorganisms, and the ways in which they are removed from water, including chlorine, ozone, and ultraviolet disinfection. The second edition of this handbook has been updated with information on biofilms and antimicrobial resistance. The impact of global warming and climate change phenomena on waterborne illnesses are also discussed. This book serves as an indispensable reference for public health microbiologists, water utility scientists, research water pollution microbiologists environmental health officers, consultants in communicable disease control and microbial water pollution students. Focuses on the microorganisms of most significance to public health, including E. coli, cryptosporidium, and enterovirus Highlights the basic microbiology, clinical features, survival in the environment, and gives a risk assessment for each pathogen Contains new material on antimicrobial resistance and biofilms Covers drinking water and both marine and freshwater recreational bathing waters

Cyanobacterial toxins are among the hazardous substances most widely found in water. They occur naturally, but concentrations hazardous to human health are usually due to human activity. Therefore, to protect human health, managing lakes, reservoirs and rivers to prevent cyanobacterial blooms is critical. This second edition of Toxic Cyanobacteria in Water presents the current state of knowledge on the occurrence of cyanobacteria and cyanotoxins as well as their impacts on health through water-related exposure pathways, chiefly drinking-water and recreational activity. It provides scientific and technical background information to support hazard identification, assessment and prioritisation of the risks posed by cyanotoxins, and it outlines approaches for their management at each step of the water-use system. It sets out key practical considerations for developing management strategies, implementing efficient measures and designing monitoring programmes. This enables stakeholders to evaluate whether there is a health risk from toxic cyanobacteria and to mitigate it with appropriate measures. This book is intended for those working on toxic cyanobacteria with a specific focus on public health protection. It intends to empower professionals from different disciplines to communicate and cooperate for sustainable management of toxic cyanobacteria, including public health workers, ecologists, academics, and catchment and waterbody managers. Ingrid Chorus headed the department for Drinking-Water and Swimming-Pool Hygiene at the German Environment Agency. Martin Welker is a limnologist and microbiologist, currently with bioMérieux in Lyon, France.

Drinking water provides an efficient source for the spread of gastrointestinal microbial pathogens capable of causing serious human disease. The massive death toll and burden of disease worldwide caused by unsafe drinking water is a compelling reason to value the privilege of having safe drinking water delivered to individual homes. On rare occasions, that privilege has been undermined in affluent nations by waterborne disease outbreaks traced to the water supply. Using the rich and detailed perspectives offered by the evidence and reports from the Canadian public inquiries into the Walkerton (2000) and North Battleford (2001) outbreaks to develop templates for understanding their key dimensions, over 60 waterborne outbreaks from 15 affluent countries over the past 30 years are explored as individual case studies. Recurring themes and patterns are revealed and the critical human dimensions are highlighted suggesting insights for more effective and more individualized preventive strategies, personnel training, management, and regulatory control. Safe Drinking Water aims to raise understanding and awareness of those factors that have most commonly contributed to or caused drinking-water-transmitted disease outbreaks - essentially a case-history analysis within the multi-barrier framework. It contains detailed analysis of the failures underlying drinking-water-transmitted disease epidemics that have been documented in the open literature, by public inquiry, in investigation reports, in surveillance databases and other reliable information sources. The book adopts a theme of 'converting hindsight into foresight', to inform drinking-water and health professionals including operators, managers, engineers, chemists and microbiologists, regulators, as well as undergraduates and graduates at specialty level. Key Features: Contains details and perspectives of major outbreaks not widely known or understood beyond those directly involved in the investigations. Technical and scientific background associated with case studies is offered in an accessible summary form. Does not require specialist training or experience to comprehend the details of the numerous outbreaks reviewed. By providing a broad-spectrum review using a consistent approach, several key recurring themes are revealed that offer insights for developing localized, tailor-made prevention strategies.

Expanding water reuse-the use of treated wastewater for beneficial purposes including irrigation, industrial uses, and drinking water augmentation-could significantly increase the nation's total available water resources. Water Reuse presents a portfolio of treatment options available to mitigate water quality issues in reclaimed water along with new analysis suggesting that the risk of exposure to certain microbial and chemical contaminants from drinking reclaimed water does not appear to be any higher than the risk experienced in at least some current drinking water treatment systems, and may be orders of magnitude lower. This report recommends adjustments to the federal regulatory framework that could enhance public health protection for both planned and unplanned (or de facto) reuse and increase public confidence in water reuse.